1
|
Ruiz MC, Serra-Prat M, Palomera E, Yildirim M, Valls J. Health inequalities and their relationship with socioeconomic indicators in the Maresme region (Catalonia): A cross-sectional ecological study. Public Health Nurs 2024; 41:1039-1048. [PMID: 39056444 DOI: 10.1111/phn.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/06/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE Health inequalities are universal, but their magnitude and determinants vary according to geographic areas, and understanding variations is essential to designing and implementing preventive and corrective policies. Our objective was to evaluate health inequalities in the Maresme region (Catalonia, Spain) and the relationship with socioeconomic indicators. DESIGN Cross-sectional ecological study (2017). SITE: Maresme region. PARTICIPANTS Population assigned to any of the Maresme's 21 basic health areas (BHAs). MEASURES Sociodemographic, socioeconomic, health, and health resource use indicators published by the Catalan Health Service's Information and Knowledge Unit. RESULTS Differences observed between BHAs were 49% in mortality, 266% in diabetes incidence, 348% in stroke incidence, and 89% in hospitalizations. In the most compared to the least disadvantaged BHAs, socioeconomic deprivation, as measured by the socioeconomic index (SEI), was 4.6 times greater and the percentage population with low educational attainment (EA) was 3.7 times higher. Greater deprivation was associated with greater prevalence of diabetes, chronic obstructive pulmonary disease, and high blood pressure, and greater incidence of diabetes, ischemic heart disease, and cancer. Likewise, a greater percentage population with low EA was associated with higher premature mortality and avoidable hospitalizations. CONCLUSION Great variation exists in socioeconomic, health, and health resource use between the different Maresme BHAs. Socioeconomic deprivation is strongly correlated with the prevalence and incidence of certain chronic diseases, and low EA is correlated with premature mortality and avoidable hospitalizations. Our findings point to the urgency of taking health inequalities into account in designing and implementing healthcare strategies, programs, and policies.
Collapse
Affiliation(s)
- Maria Carmen Ruiz
- Nursing Directorate, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Mateu Serra-Prat
- Research Unit, Consorci Sanitari del Maresme, Barcelona, Spain
- Centre for Networked Biomedical Research, Liver and Digestive Diseases (CIBER-EHD), Madrid, Spain
| | | | - Meltem Yildirim
- Methodology, Methods, Models and Outcomes of Health and Social Sciences Research Group (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia, Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Jordi Valls
- Management, Consorci Sanitari del Maresme, Barcelona, Spain
| |
Collapse
|
2
|
González-de-Julián S, Vivas-Consuelo D, Barrachina-Martínez I. Modelling efficiency in primary healthcare using the DEA methodology: an empirical analysis in a healthcare district. BMC Health Serv Res 2024; 24:982. [PMID: 39182078 PMCID: PMC11344926 DOI: 10.1186/s12913-024-11420-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/09/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Primary healthcare management efficiency conditions the functioning of specialized care and has a direct impact on the outcomes of the health system and its sustainability. The objective of this research is to develop models to evaluate the efficiency, including health outcomes, of the primary healthcare centres (PHC) of the Clínico - La Malvarrosa Health District in Valencia. METHODS To evaluate efficiency, Data Envelopment Analysis (DEA) was used with output orientation and variable returns to scale, with panel data from the years 2015 to 2019. In rates per 10,000 inhabitants, the inputs are: medical and nursing staff and pharmacy cost. The outputs are: number of consultations, hospital emergencies, referrals, avoidable hospitalisations, avoidable mortality and pharmaceutical prescription efficiency. As exogenous variables: the percentage of population over 65 years old, over 80 and case-mix. Three models were developed, all of them with the same inputs and different combinations of outputs related to: healthcare activity, outcomes, and both, in order to study the influence of the different approaches on efficiency. Each model is analysed both without exogenous variables and with each of them. RESULTS The efficiency results vary depending on the model used, although certain PHCs are always on, or very close to, the efficient frontier, while others are always inefficient. When healthcare activity outputs are considered, efficiency scores improve and the number of efficient PHCs increases. However, in general, the PHC score decreases throughout the evaluated period. This decrease is more pronounced when only activity outputs are included. CONCLUSIONS DEA allows the inefficiencies of PHCs to be analysed and the efficient ones are clearly distinguished from the inefficient, although different efficiency scores are obtained depending on the model used. Evaluation can be according to healthcare activity, health outcomes or both, making it necessary to identify the expected objectives of the PHCs, as the perspective of the analysis influences the results.
Collapse
Affiliation(s)
- Silvia González-de-Julián
- Research Unit for Health Economics and Management, Universitat Politècnica de València, Valencia, 46022, Spain.
| | - David Vivas-Consuelo
- Research Unit for Health Economics and Management, Universitat Politècnica de València, Valencia, 46022, Spain
| | - Isabel Barrachina-Martínez
- Research Unit for Health Economics and Management, Universitat Politècnica de València, Valencia, 46022, Spain
| |
Collapse
|
3
|
Coma E, Martinez-Marcos M, Hermosilla E, Mendioroz J, Reñé A, Fina F, Perramon-Malavez A, Prats C, Cereza G, Ciruela P, Pineda V, Antón A, Ricós-Furió G, Soriano-Arandes A, Cabezas C. Effectiveness of nirsevimab immunoprophylaxis against respiratory syncytial virus-related outcomes in hospital and primary care settings: a retrospective cohort study in infants in Catalonia (Spain). Arch Dis Child 2024; 109:736-741. [PMID: 38857952 PMCID: PMC11347209 DOI: 10.1136/archdischild-2024-327153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/16/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND In Catalonia, infants under 6 months old were eligible to receive nirsevimab, a novel monoclonal antibody against respiratory syncytial virus (RSV). We aimed to analyse nirsevimab's effectiveness across primary and hospital care outcomes. METHODS Retrospective cohort study from 1 October 2023 to 31 January 2024, including all infants born between April and September 2023. We established two cohorts based on nirsevimab administration (immunised and non-immunised). We followed individuals until the earliest moment of an outcome-RSV infection, primary care attended bronchiolitis and pneumonia, hospital emergency visits due to bronchiolitis, hospital admission or intensive care unit (ICU) admission due to RSV bronchiolitis-death or the end of the study. We used the Kaplan-Meier estimator and fitted Cox regression models using a calendar time scale to estimate HRs and their 95% CIs. RESULTS Among 26 525 infants, a dose of nirsevimab led to an adjusted HR for hospital admission due to RSV bronchiolitis of 0.124 (95% CI: 0.086 to 0.179) and an adjusted HR for ICU admission of 0.099 (95% CI: 0.041 to 0.237). Additionally, the adjusted HRs observed for emergency visits were 0.446 (95% CI: 0.385 to 0.516) and 0.393 (95% CI: 0.203 to 0.758) for viral pneumonia, 0.519 (95% CI: 0.467 to 0.576) for bronchiolitis attended in primary care and 0.311 (95% CI: 0.200 to 0.483) for RSV infection. CONCLUSION We demonstrated nirsevimab's effectiveness with reductions of 87.6% and 90.1% in hospital and ICU admissions, respectively. These findings offer crucial guidance for public health authorities in implementing RSV immunisation campaigns.
Collapse
Affiliation(s)
- Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Catala de la Salut, Barcelona, Spain
| | | | - Eduardo Hermosilla
- Primary Care Services Information System (SISAP), Institut Catala de la Salut, Barcelona, Spain
- Idiap Jordi Gol, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Jacobo Mendioroz
- Public Health Secretariat, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Anna Reñé
- Primary Care Services Information System (SISAP), Institut Catala de la Salut, Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Catala de la Salut, Barcelona, Spain
| | - Aida Perramon-Malavez
- Computational Biology and Complex Systems (BIOCOM-SC) Group, Departament de Fisica, Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Clara Prats
- Computational Biology and Complex Systems (BIOCOM-SC) Group, Departament de Fisica, Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Gloria Cereza
- Catalan Centre of Pharmacovigilance. Directorate-General for Healthcare Planning and Regulation, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Ciruela
- Public Health Secretariat, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Valentí Pineda
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitari Parc Taulí, Hospital de Sabadell, Sabadell, Spain
| | - Andrés Antón
- Respiratory Virus Unit, Microbiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Gemma Ricós-Furió
- Pediatric's Coordinator of Primary and Community Care, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
- Pediatric's Coordinator of Primary and Community Care, Institut Català de la Salut, Barcelona, Spain
| | - Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital, Hospital Vall d'Hebron, Barcelona, Spain
| | - Carmen Cabezas
- Public Health Secretariat, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| |
Collapse
|
4
|
Vives N, Travier N, Farre A, Binefa G, Vidal C, Pérez Lacasta MJ, Ibáñez-Sanz G, Niño de Guzmán EP, Panera JA, Garcia M. Effectiveness and Acceptability of Targeted Text Message Reminders in Colorectal Cancer Screening: Randomized Controlled Trial (M-TICS Study). JMIR Public Health Surveill 2024; 10:e57959. [PMID: 39083331 PMCID: PMC11325104 DOI: 10.2196/57959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/30/2024] [Accepted: 06/08/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Mobile phone-based SMS text message reminders have the potential to improve colorectal cancer screening participation rates. OBJECTIVE This study assessed the effectiveness and acceptability of adding targeted SMS text message reminders to the standard procedure for those who picked up but did not return their screening kit at the pharmacy within 14 days in a colorectal cancer screening program in Catalonia, Spain. METHODS We performed a randomized control trial among individuals who picked up a fecal immunochemical test (FIT) kit for colorectal cancer screening at the pharmacy but did not return it within 14 days. The intervention group (n=4563) received an SMS text message reminder on the 14th day of kit pick up and the control group (n=4806) received no reminder. A 30-day reminder letter was sent to both groups if necessary. The main primary outcome was the FIT completion rate within 30, 60, and 126 days from FIT kit pick up (intention-to-treat analysis). A telephone survey assessed the acceptability and appropriateness of the intervention. The cost-effectiveness of adding an SMS text message reminder to FIT completion was also performed. RESULTS The intervention group had higher FIT completion rates than the control group at 30 (64.2% vs 53.7%; P<.001), 60 (78.6% vs 72.0%; P<.001), and 126 (82.6% vs 77.7%; P<.001) days. Participation rates were higher in the intervention arm independent of sex, age, socioeconomic level, and previous screening behavior. A total of 339 (89.2%) interviewees considered it important and useful to receive SMS text message reminders for FIT completion and 355 (93.4%) preferred SMS text messages to postal letters. We observed a reduction of US $2.4 per participant gained in the intervention arm for invitation costs compared to the control arm. CONCLUSIONS Adding an SMS text message reminder to the standard procedure significantly increased FIT kit return rates and was a cost-effective strategy. SMS text messages also proved to be an acceptable and appropriate communication channel for cancer screening programs. TRIAL REGISTRATION ClinicalTrials.gov NCT04343950; https://www.clinicaltrials.gov/study/NCT04343950. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1371/journal.pone.0245806.
Collapse
Affiliation(s)
- Nuria Vives
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Noemie Travier
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Albert Farre
- School of Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Gemma Binefa
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Maria Jose Pérez Lacasta
- Department of Economics, University Rovira i Virgili, Reus, Spain
- Research Group Economic Challenges for the Next Generation (ECO-NEXT), Reus, Spain
- Research Center on Economics and Sustainability (ECO-SOS), Reus, Spain
| | - Gemma Ibáñez-Sanz
- Gastroenterology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain
| | - Ena Pery Niño de Guzmán
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Vall d' Hebron University Hospital, Barcelona, Spain
| | - Jon Aritz Panera
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Montse Garcia
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| |
Collapse
|
5
|
López-Bazo E. The complex link between socioeconomic deprivation and COVID-19. Evidence from small areas of Catalonia. Spat Spatiotemporal Epidemiol 2024; 49:100648. [PMID: 38876561 DOI: 10.1016/j.sste.2024.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 01/20/2024] [Accepted: 03/11/2024] [Indexed: 06/16/2024]
Abstract
This ecological study assesses the association between the incidence rate of COVID-19 confirmed cases and socioeconomic deprivation in the Catalan small areas for the first six waves of the pandemic. The association is estimated using Poisson regressions and, in contrast to previous studies, considering that the relationship is not linear but rather depends on the degree of deprivation. The results show that the association between deprivation and incidence varied between waves, not only in intensity but also in its sign. Although it was insignificant in the first, third and fourth waves, the association was positive and significant in the second, becoming significantly negative in the fifth and sixth waves. Interestingly, the evidence suggests that the link between both magnitudes was not homogeneous throughout the distribution of deprivation, the pattern also varying between waves. The results are discussed in view of the role of non-pharmacological interventions and vaccination, as well as potential biases (for example that associated with differences between population groups in the propensity to be tested in each wave).
Collapse
Affiliation(s)
- Enrique López-Bazo
- AQR-University of Barcelona, Av. Diagonal 690, Barcelona E-08034, Spain.
| |
Collapse
|
6
|
Rodoreda-Pallàs B, Torra Escarrer E, Sanahuja Juncadella J, Pampalona Cardona T, Solanas Bacardit N, Vilarrubias Calaf M. [Evaluation of a coding guide on social determinants of health in primary care consultations: A mixed study]. Aten Primaria 2024; 56:102878. [PMID: 38401205 PMCID: PMC10904901 DOI: 10.1016/j.aprim.2024.102878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/03/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE To evaluate a coding guide for social determinants of health in primary care consultations as an effective tool in the professional's daily workflow. DESIGN Mixed sequential explanatory study. Formed by a quantitative part (experimental) and a qualitative part (descriptive-evaluative). LOCATION All the primary care teams of the Central Catalonia Management (32 teams). PARTICIPANTS AND SETTING All nursing, social work and medical professionals working in the 32 primary care teams of the Catalan Institute of Health in Central Catalonia from February 2023 to July 2023. METHODS A social determinants of health coding guide was developed. This guide was created in a multidisciplinary and multicenter manner. Purposive sampling. Quantitatively, the number of diagnoses recorded by the experimental group versus the control group was counted. Qualitatively, a thematic analysis was carried out from a socio-constructivist perspective. RESULTS The results were significant and satisfactory. Using a quantitative methodology, the effectiveness of the use of the guide was assessed. A significant increase in the use of the social determinants was observed in the intervention group vs. the control group, with a percentage of post-intervention use of 19.53% in the control group and 32.26% in the intervention group (P < .001). The number of diagnoses recorded increased from 312 to 1322 in the intervention group, while it remained the same in the control group. The main factors identified through qualitative methodology that may explain the effectiveness of the guideline were: 1) the effectiveness of the guideline among primary care professionals, 2) the appropriateness of the guideline by assessing its usefulness and practicality, 3) feasibility and 4) specific contributions to the improvement of the guideline. CONCLUSIONS The social determinants of health coding guide is effective, appropriate and can be implemented in the workflow of primary health care professionals for good recording of the social determinants of health.
Collapse
Affiliation(s)
- Berta Rodoreda-Pallàs
- Grup d'Investigació Promoció de la Salut en l' Àmbit Rural, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Barcelona, España; Centre d'Atenció Primària de Santpedor,EAP Navarcles/Sant Fruitós/Santpedor, Bages, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España.
| | - Eva Torra Escarrer
- Centre d'Atenció Primària de Sant Vicenç de Castellet, EAP Sant Vicenç de Castellet, Bages, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España
| | - Jaume Sanahuja Juncadella
- Centre d'Atenció Primària de Plaça Catalunya, EAP Plaça Catalunya, Bages, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España
| | - Teresa Pampalona Cardona
- Centre d'Atenció Primària de Cardona, EAP Cardona, Bages, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España
| | - Nuria Solanas Bacardit
- Centre d'Atenció Primària de Cardona, EAP Cardona, Bages, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España
| | - Montserrat Vilarrubias Calaf
- Centre d'Atenció Primària de Anoia Rural, EAP Anoia Rural, Anoia, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España
| |
Collapse
|
7
|
Martínez-Marcos M, Reñé-Reñé A, Zabaleta-Del-Olmo E, Guiriguet C, Gómez-Durán EL, Cabezas-Peña C. Measles, mumps, and rubella vaccination coverage: an ecological study of primary health care and socio-economic factors in Catalonia, Spain. J Public Health Policy 2024; 45:299-318. [PMID: 38664542 DOI: 10.1057/s41271-024-00484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 06/16/2024]
Abstract
This study examined the association of socio-economic factors and the structure of primary care centres (PCCs) with measles, mumps, and rubella (MMR) vaccination coverage among the 8-year-old population in Catalonia, Spain. We conducted an ecological study to retrospectively assess the MMR vaccination-recorded status of children born in 2012, using public health data extracted in December 2020. For each of 300 PCCs serving 70,498 children, we calculated vaccination coverage rates from electronic health records and linked these rates to a composite deprivation index corresponding to the territory served by each PCC. We identified a relationship between unfavourable socio-economic factors and higher recorded vaccination coverage. On average, directly managed PCCs had higher vaccination coverage rates than indirectly managed PCCs. Greater utilisation of primary care services by the population was also associated with higher vaccination coverage rates. Further research is needed to generate knowledge valuable for informing more equitable child-vaccination service delivery models.
Collapse
Affiliation(s)
- Montse Martínez-Marcos
- Preventive Medicine Service, Sub-directorate General for Health Promotion, Secretariat of Public Health, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Anna Reñé-Reñé
- Central Vaccine Registry Management Team, Institut Català de la Salut, Girona, Spain
| | - Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.
- Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain.
| | - Carolina Guiriguet
- Sistema d'Informació dels Serveis d'Atenció Primària (SISAP), Healthcare Management, Information Systems Directorate, Institut Català de la Salut, Barcelona, Spain
- Gotic Primary Care Centre, Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
| | | | - Carmen Cabezas-Peña
- Sub-directorate General for Health Promotion, Secretariat of Public Health, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| |
Collapse
|
8
|
Iruela Sánchez M, García-Sierra R, Lladó Blanch M, Naveros Almenara F, Seda G, Torán-Monserrat P. [Typology of wounds treated in primary care: Multicenter cross-sectional study]. Semergen 2023; 49:101964. [PMID: 37075519 DOI: 10.1016/j.semerg.2023.101964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND The care of people with skin wounds is an important health problem, that affect the quality of life of patients and their families, and has a great socioeconomic impact. Knowing the situation of the problem is the first step for different health approaches. In our territory since 2010 no type of follow-up has been carried out on the wounds that we are treating, we propose to know the typology and characteristics of active wounds in the population assisted by Primary Care. METHODS Multicenter cross-sectional descriptive study carried out in a metropolitan area of Catalonia in Primary Care Teams and residences. Participants were all patients with active wounds. A record made by the patient's referring nurses was used. A descriptive analysis of the data was performed. RESULTS About 1,978 people participated, presenting 2,471 injuries. The overall prevalence was 0.22%. At home patients, the prevalence was 3.58% and in nursing homes, 6.56%. Of all the lesions, 46.5% were acute and 53.4% chronic, the mean size was 3.13cm. Of the chronic wounds, 345 (26.2%) had an evolution of more than 1year. The most prevalent injuries were venous ulcers in Primary Care Teams and categoryII pressure injuries in residential centers. CONCLUSIONS The results of this study present an objective reality about the injuries that are treated in primary care, both in Primary Care Centers, homes or residences, as well as their description.
Collapse
Affiliation(s)
- M Iruela Sánchez
- Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Barcelona, España; Grup de Recerca Multidisciplinar en Salut i Societat 2021 SGR 01484, Mataró, Barcelona, España
| | - R García-Sierra
- Grup de Recerca Multidisciplinar en Salut i Societat 2021 SGR 01484, Mataró, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Barcelona, España; Departamento de Enfernería, Facultad de Medicina, Campus Bellaterra, Universitat Autònoma de Barcelona, Barcelona, España; Grupo de Atención Primaria, Instituto Germans Trias i Pujol, Badalona, Barcelona, España.
| | - M Lladó Blanch
- Direcció d'Atenció Primaria Metropolitana Nord, Servei d'Atenció Primaria Barcelonès Nord-Maresme, Institut Català de la Salut
| | - F Naveros Almenara
- Direcció d'Atenció Primaria Metropolitana Nord, Servei d'Atenció Primària Vallès Occidental, EAP Sant Quirze del Vallès, Institut Català de la Salut, Sant Quirze del Vallès, Barcelona, España
| | - G Seda
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Barcelona, España
| | - P Torán-Monserrat
- Grup de Recerca Multidisciplinar en Salut i Societat 2021 SGR 01484, Mataró, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, Barcelona, España; Grupo de Atención Primaria, Instituto Germans Trias i Pujol, Badalona, Barcelona, España; Facultad de Medicina, Universitat de Girona, Girona, España
| |
Collapse
|
9
|
Martin-Iguacel R, Reyes-Urueña J, Bruguera A, Aceitón J, Díaz Y, Moreno-Fornés S, Domingo P, Burgos-Cibrian J, Tiraboschi JM, Johansen IS, Álvarez H, Miró JM, Casabona J, Llibre JM. Determinants of long-term survival in late HIV presenters: The prospective PISCIS cohort study. EClinicalMedicine 2022; 52:101600. [PMID: 35958520 PMCID: PMC9358427 DOI: 10.1016/j.eclinm.2022.101600] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 12/30/2022] Open
Abstract
Background Late HIV diagnosis (i.e CD4≤350 cells/µL) is associated with poorer outcomes. However, determinants of long-term mortality and factors influencing immune recovery within the first years after antiretroviral treatment (ART) initiation are poorly defined. Methods From PISCIS cohort, we included all HIV-positive adults, two-year survivors after initiating ART between 2005-2019. The primary outcome was all-cause mortality according to the two-year CD4 count. We used Poisson regression. The secondary outcome was incomplete immune recovery (i.e., two-year CD4<500 cells/µL). We used logistic regression and propensity score matching. Findings We included 2,719 participants (16593·1 person-years): 1441 (53%) late presenters (LP) and 1278 non-LP (1145 non-LP with two-year CD4 count >500 cells/µL, reference population). Overall, 113 patients (4·2%) died. Mortality was higher among LP with two-year CD4 count 200-500 cells/µL (aMRR 1·95[95%CI:1·06-3·61]) or <200 cells/µL (aMRR 4·59[2·25-9·37]).Conversely, no differences were observed in participants with two-year CD4 counts >500 cells/µL, regardless of being initially LP or non-LP (aMRR 1·05[0·50-2·21]). Mortality rates within each two-year CD4 strata were not affected by the initial CD4 count at ART initiation (test-interaction, p = 0·48). The stronger factor influencing immune recovery was the CD4 count at ART initiation. First-line integrase-inhibitor-(INSTI)-based regimens were associated with reduced mortality compared to other regimens (aMRR 0·54[0·31-0·93]) and reduced risk of incomplete immune recovery in LP (aOR 0·70[0·52-0·95]). Interpretation Two-year immune recovery is a good early predictor of long-term mortality in LP after surviving the first high-risk 2 years. Nearly half experienced a favorable immune recovery with a life expectancy similar to non-LP. INSTI-based regimens were associated with higher rates of successful immune recovery and better survival compared to non-INSTI regimens. Funding Southern-Denmark University, Danish AIDS-foundation, and Region of Southern Denmark.
Collapse
Affiliation(s)
- Raquel Martin-Iguacel
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Andreu Bruguera
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Jordi Aceitón
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Yesika Díaz
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Sergio Moreno-Fornés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Pere Domingo
- Infectious Diseases Unit, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Joaquín Burgos-Cibrian
- Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
| | - Juan Manuel Tiraboschi
- Department of Internal Medicine and Infectious Diseases, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Josep M Miró
- Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain
- Fundació Institut D'investigació En Ciències De La Salut Germans Trias I Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep M Llibre
- Infectious Diseases Department and Fight Infections Foundation, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - PISCIS study group
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Infectious Diseases Unit, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
- Department of Internal Medicine and Infectious Diseases, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
- Infectious Diseases Unit, University Hospital of Ferrol, Spain
- Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain
- Fundació Institut D'investigació En Ciències De La Salut Germans Trias I Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Infectious Diseases Department and Fight Infections Foundation, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| |
Collapse
|
10
|
Zelenina A, Shalnova S, Maksimov S, Drapkina O. Classification of Deprivation Indices That Applied to Detect Health Inequality: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10063. [PMID: 36011694 PMCID: PMC9408665 DOI: 10.3390/ijerph191610063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Many studies around the world are undertaken to establish the association between deprivation and public health indicators. Both separate indicators (e.g., income, education, occupation, public security and social support) and complex models (indices) include several indicators. Deprivation indices are actively used in public health since the mid 1980s. There is currently no clear classification of indices. METHODS In the current review, data related to deprivation indices are combined and analyzed in order to create a taxonomy of indices based on the results obtained. The search was carried out using two bibliographic databases. After conducting a full-text review of the articles and searching and adding relevant articles from the bibliography, and articles that were already known to the authors, sixty studies describing the use of sixty deprivation indices in seventeen countries were included in the narrative synthesis, resulting in development of a taxonomy of indices. When creating the taxonomy, an integrative approach was used that allows integrating new classes and sub-classes in the event that new information appears. RESULTS In the review, 68% (41/60) of indices were classified as socio-economic, 7% (4/60) of indices as material deprivation, 5% (3/60) of indices as environmental deprivation and 20% (12/60) as multidimensional indices. CONCLUSIONS The data stimulates the use of a competent approach, and will help researchers and public health specialist in resolving conflicts or inconsistencies that arise during the construction and use of indices.
Collapse
Affiliation(s)
- Anastasia Zelenina
- National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Petroverigskiy per. 10, 101990 Moscow, Russia
| | | | | | | |
Collapse
|
11
|
Prevalence of SARS-CoV-2 antibodies and risk factors in the pandemic epicentre of Catalonia. Sci Rep 2022; 12:9169. [PMID: 35654922 PMCID: PMC9163094 DOI: 10.1038/s41598-022-13290-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/09/2022] [Indexed: 11/14/2022] Open
Abstract
To define the seroprevalence of antibodies against SARS-CoV-2 in the municipality of Vilanova del Camí (in the region of Conca d'Ódena, Barcelona, Spain) and to know the risk factors associated with positive seroprevalence. Cross-sectional descriptive study. The population of Vilanova del Camí had the opportunity to voluntarily attend two screenings (October and December 2020) for antibodies against the nucleocapsid protein of SARS-CoV-2 using a Rapid Diagnostic Test (RDT) (Salocor (Salofa Oy). Participants in the screening signed an informed consent form. From the 3,610 attendees at the screening, 2,170 patients were randomly selected. The relationship between antibody test results and other demographic (sex, age, morbidity index) and clinical (diagnoses, smoking and drugs) variables was analysed. The prevalence of antibodies against SARS-CoV-2 was 9.6% (95% CI of 8.4% to 10.9%) and was similar for men and women but increased with age. Among complex chronic patients, 14.3% had antibodies against SARS-CoV-2, and among patients with advanced chronic disease, 25% had antibodies against SARS-CoV-2. Age, AMG (Adjusted Morbidity Groups) index, COVID-19 diagnosis and contact with a COVID-19 case were risk factors for positive seroprevalence. A higher seroprevalence was detected in the October screening (12.16%) than in the December screening (8.38%). In the December screening, obesity was a risk factor for positive seroprevalence. This study demonstrates the high seroprevalence of antibodies against SARS-CoV-2 in the pandemic epicentre of Catalonia.
Collapse
|
12
|
Impacto de la fragilidad en la enfermedad por COVID-19 en una cohorte de gente mayor de la ciudad de Barcelona. Aten Primaria 2022; 54:102393. [PMID: 35779366 PMCID: PMC9125044 DOI: 10.1016/j.aprim.2022.102393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/06/2022] [Accepted: 05/14/2022] [Indexed: 12/02/2022] Open
Abstract
Objetivo Describir la incidencia y mortalidad de COVID-19, durante la primera ola, en la población de personas mayores de Barcelona, según sus niveles previos de fragilidad. Diseño Estudio de cohortes retrospectivo. Emplazamiento y participantes Población de 65 o más años asignada a los centros de Atención Primaria de Barcelona del Institut Català de la Salut, seguidos entre marzo y junio de 2020. Mediciones principales Fragilidad calculada al inicio a partir de la historia clínica informatizada. Resultados durante el seguimiento: diagnóstico de COVID-19, posible o confirmado con PCR y mortalidad por todas las causas. Resultados Se analizaron 251788 mayores de 64 años. Un 61,3% tenían algún nivel de fragilidad, 27,8% moderada o grave. La incidencia de COVID-19 fue de 3,13 casos por 100 habitantes (N = 7883) y la mortalidad por COVID-19 fue del 21,5% (N =1 691). Tanto la incidencia como la mortalidad por COVID-19 fueron superiores a mayor edad, en hombres, a mayor privación y a mayor nivel de fragilidad. Los individuos con fragilidad leve, moderada y grave tuvieron un hazard ratio ajustado de enfermedad por COVID-19 de 1,47, 2,08 y 3,50 respectivamente. Entre los sujetos con COVID-19, aquéllos con fragilidad leve, moderada y grave tuvieron un hazard ratio ajustado de mortalidad por COVID-19 de 1,44, 1,69 y 2,47 respectivamente. Conclusiones Consideramos necesario el abordaje de la fragilidad también en situación de pandemia, dado que es una condición tratable y a su vez factor de riesgo de COVID-19 más grave, donde el papel de la Atención Primaria es primordial, por su accesibilidad y longitudinalidad.
Collapse
|
13
|
Álvarez-Martín C, Ribera A, Marsal JR, Ariza-Solé A, Pérez-Hoyos S, Oristrell G, Soriano-Colomé T, Romaguera R, Pijoan JI, Lidón RM, Mauri J, Ferreira-González I. Dynamics of Emergency Cardiovascular Hospital Admissions and In-Hospital Mortality During the COVID-19 Pandemic: Time Series Analysis and Impact of Socioeconomic Factors. Front Cardiovasc Med 2022; 9:827212. [PMID: 35557541 PMCID: PMC9087754 DOI: 10.3389/fcvm.2022.827212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Aims This study aimed to evaluate the decline in urgent cardiovascular hospital admissions and in-hospital mortality during the COVID pandemic in two successive waves, and to evaluate differences by sex, age, and deprivation index subgroups. Methods and Results We obtained acute cardiovascular hospital episodes during the years 2019-2020 from region-wide data on public healthcare usage for the population of Catalonia (North-East Spain). We fitted time models to estimate the incidence rate ratios (IRRs) of the acute coronary syndrome (ACS) and acute heart failure (HF) admissions during the first pandemic wave, the between-waves period, and the second wave compared with the corresponding pre-COVID-19 periods and to test for the interaction with sex, age, and area-based socioeconomic level. We evaluated the effect of COVID-19 period on in-hospital mortality. ACS (n = 8,636) and HF (n = 27,566) episodes were defined using primary diagnostic ICD-10 codes. ACS and HF admissions decreased during the first wave (IRR = 0.66, 95%CI: 0.58-0.76 and IRR = 0.61, 95% CI: 0.55-0.68, respectively) and during the second wave (IRR = 0.80, 95%CI: 0.72-0.88 and IRR = 0.76, 95%CI: 0.69-0.84, respectively); acute HF admissions also decreased in the period between waves (IRR: 0.81, 95%CI: 0.74-0.89). The impact was similar in all sex and socioeconomic subgroups and was higher in older patients with ACS. In-hospital mortality was higher than expected only during the first wave. Conclusion During the first wave of the COVID-19 pandemic, there was a marked decline in urgent cardiovascular hospital admissions that were attenuated during the second wave. Both the decline and the attenuation of the effect have been similar in all subgroups regardless of age, sex, or socioeconomic status. In-hospital mortality for ACS and HF episodes increased during the first wave, but not during the second wave.
Collapse
Affiliation(s)
- Claudia Álvarez-Martín
- Cardiovascular Research and Epidemiology Unit, Cardiology Department, University Hospital Vall d’Hebron and Vall d’Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Aida Ribera
- Cardiovascular Research and Epidemiology Unit, Cardiology Department, University Hospital Vall d’Hebron and Vall d’Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Recerca en Envelliment, Fragilitat i Transicions (REFiT) Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Institute of Research, Barcelona, Spain
| | - Josep Ramon Marsal
- Cardiovascular Research and Epidemiology Unit, Cardiology Department, University Hospital Vall d’Hebron and Vall d’Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Albert Ariza-Solé
- Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Bioheart, Grup de Malalties Cardiovasculars, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Santiago Pérez-Hoyos
- Statistics and Bioinformatics Unit, Vall d’Hebron Research Institute, Barcelona, Spain
- Statistics Department, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Gerard Oristrell
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Toni Soriano-Colomé
- Cardiology Department, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Romaguera
- Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Bioheart, Grup de Malalties Cardiovasculars, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Jose Ignacio Pijoan
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Clinical Epidemiology Unit, Hospital Universitario Cruces/BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
| | - Rosa M. Lidón
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josepa Mauri
- Cardiology Department, Hospital German Trias i Pujol, Barcelona, Spain
- Director Plan for Cardiovascular Diseases, Pla Director de Malalties Cardiovasculars (PDMCV), Department of Health, Catalan Government, Barcelona, Spain
| | - Ignacio Ferreira-González
- Cardiovascular Research and Epidemiology Unit, Cardiology Department, University Hospital Vall d’Hebron and Vall d’Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cardiology Department, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
14
|
Recalde M, Rodríguez C, Burn E, Far M, García D, Carrere-Molina J, Benítez M, Moleras A, Pistillo A, Bolíbar B, Aragón M, Duarte-Salles T. Data Resource Profile: The Information System for Research in Primary Care (SIDIAP). Int J Epidemiol 2022; 51:e324-e336. [PMID: 35415748 PMCID: PMC9749711 DOI: 10.1093/ije/dyac068] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/29/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
| | | | - Edward Burn
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
| | - Marc Far
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Darío García
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Jordi Carrere-Molina
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Mencia Benítez
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Anna Moleras
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Bonaventura Bolíbar
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - María Aragón
- Corresponding author. Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain. E-mail:
| | | |
Collapse
|
15
|
Agustí C, Cunillera O, Almeda J, Mascort J, Carrillo R, Olmos C, Montoliu A, Alberny M, Molina I, Cayuelas L, Casabona J. Efficacy of an electronic reminder for HIV screening in primary healthcare based on indicator conditions in Catalonia (Spain). HIV Med 2022; 23:868-879. [DOI: 10.1111/hiv.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Cristina Agustí
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT) Department of Health Generalitat of Catalunya Badalona Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
| | - Oriol Cunillera
- Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol) Barcelona Spain
| | - Jesús Almeda
- Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol) Barcelona Spain
- Research Support Unit Primary Health General Directorate of Costa de Ponent Catalan Institute of Health (ICS) Cornellà de Llobregat Spain
| | - Juanjo Mascort
- Catalan Society of Family and Community Medicine (CAMFiC) Barcelona Spain
- Spanish Society of Family and Community Medicine (semFYC) Barcelona Spain
- Department of Clinical Sciences Faculty of Medicine University of Barcelona (UB) Barcelona Spain
| | - Ricard Carrillo
- Catalan Society of Family and Community Medicine (CAMFiC) Barcelona Spain
- Spanish Society of Family and Community Medicine (semFYC) Barcelona Spain
| | - Carmen Olmos
- Health Department Catalan Government Barcelona Spain
| | - Alexandra Montoliu
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
- Unit of Infections and Cancer ‐ Information and Interventions (UNIC ‐ I&I) Cancer Epidemiology Research Program (CERP) Hospitalet de Llobregat Barcelona Spain
| | - Mireia Alberny
- Medical Management of Primary Care Servicies STI/HIV Area Catalan Institute of Health (ICS) Barcelona Spain
| | - Izarbe Molina
- Association of Family and Community Nursing of Catalonia (AIFiCC) Barcelona Spain
| | - Laia Cayuelas
- Centro de Atención Primaria Casanova Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE) Barcelona Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT) Department of Health Generalitat of Catalunya Badalona Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine Universitat Autónoma de Barcelona Badalona Spain
| |
Collapse
|
16
|
Ibáñez-Sanz G, Milà N, Vives N, Vidal C, Binefa G, Rocamora J, Atencia C, Moreno V, Sanz-Pamplona R, Garcia M. Diagnostic Performance of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program According to Ambient Temperature and Humidity. Cancers (Basel) 2022; 14:cancers14051153. [PMID: 35267461 PMCID: PMC8909312 DOI: 10.3390/cancers14051153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 02/05/2023] Open
Abstract
Exposure of the fecal immunochemical test (FIT) to different ambient temperatures and humidity is unavoidable in population-based screening programs in Southern European countries, and it could lead to a decrease in target colorectal lesions. The objective was to evaluate the effect of ambient temperature and humidity on the FIT sensitivity in a population-based screening program for colorectal cancer (CRC) using an ecological design. The retrospective cohort included individuals aged 50−69 years who participated in CRC screening (Barcelona) from 2010−2015, and were followed until 2017 to identify interval CRCs. The positivity rate, and detection rates for advanced polyps and CRC were compared according to ambient temperature, humidity, and quarters of the year. A positive FIT was defined as the detection of ≥20 μg Hb/g in feces. The monthly ambient temperature and humidity were recorded on the day that the FIT was performed. In total, 92,273 FIT results from 53,860 participants were analyzed. The FIT positivity rate was lower at >24 °C than at ≤24 °C (p = 0.005) but was not affected by humidity. The temperature’s impact on positivity did not lead to a decrease in the FIT detection rate for advanced neoplasia or the interval cancer detection rate in a program where the samples were refrigerated until the analysis and screening invitations were discontinued in July and August.
Collapse
Affiliation(s)
- Gemma Ibáñez-Sanz
- Oncology Data Analytics Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.I.-S.); (J.R.); (C.A.); (V.M.); (R.S.-P.)
- Gastroenterology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- Colorectal Cancer Research Group, ONCOBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
| | - Núria Milà
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (N.V.); (C.V.)
- Early Detection of Cancer Research Group, EPIBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Núria Vives
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (N.V.); (C.V.)
- Early Detection of Cancer Research Group, EPIBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (N.V.); (C.V.)
- Early Detection of Cancer Research Group, EPIBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Gemma Binefa
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (N.V.); (C.V.)
- Early Detection of Cancer Research Group, EPIBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Judith Rocamora
- Oncology Data Analytics Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.I.-S.); (J.R.); (C.A.); (V.M.); (R.S.-P.)
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
| | - Carmen Atencia
- Oncology Data Analytics Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.I.-S.); (J.R.); (C.A.); (V.M.); (R.S.-P.)
| | - Víctor Moreno
- Oncology Data Analytics Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.I.-S.); (J.R.); (C.A.); (V.M.); (R.S.-P.)
- Colorectal Cancer Research Group, ONCOBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
- Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
| | - Rebeca Sanz-Pamplona
- Oncology Data Analytics Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.I.-S.); (J.R.); (C.A.); (V.M.); (R.S.-P.)
- Colorectal Cancer Research Group, ONCOBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
| | - Montse Garcia
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (N.M.); (G.B.)
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, 08907 Barcelona, Spain; (N.V.); (C.V.)
- Early Detection of Cancer Research Group, EPIBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-932-60-71-86
| | | |
Collapse
|
17
|
Modelling Deprivation Level and Multimorbidity in a Health District. MATHEMATICS 2022. [DOI: 10.3390/math10040659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Deprivation is associated with an increased risk of developing chronic health conditions and with worse outcomes in multimorbidity. The goal of our study was to develop an integrated population index of deprivation (IPID) to observe the influence of deprivation on morbidity and the subsequent use of healthcare resources in one health district, using the socioeconomic, clinical and geographical data from its administrative health records. Eight socioeconomic indicators were identified and weighted using the methodology of two-phase principal component analysis, providing an index that allowed each census section to be classified into seven deprivation groups. Secondly, the possible relation between the IPID and the variables for multimorbidity and healthcare resources was analysed using the theory of multiple comparisons. It was observed that places with a greater proportion of healthy people presented lower values of deprivation and that, at lower levels of deprivation, there were fewer hospital admissions. The results show that living in an area with a higher deprivation index is associated with greater consumption of healthcare resources and disease burden. Identifying areas of sociosanitary vulnerability can help to identify health inequalities and allow intervention by clinical practices and healthcare management to reduce them.
Collapse
|
18
|
Sentís A, Torán P, Esperalba J, Agustí C, Ángel M, Fernández MG, Dopico E, Salvador-González B, González MV, Bordas A, Antón A, Violan C, Montoro-Fernández M, Aceiton J, Egea-Cortés L, Alonso L, Dacosta-Aguayo R, Calatayud L, Lejardi Y, Mendioroz J, Basora J, Reyes-Urueña J, Casabona J. Monitoring of SARS-CoV-2 seroprevalence among primary healthcare patients in the Barcelona Metropolitan Area: the SeroCAP sentinel network protocol. BMJ Open 2022; 12:e053237. [PMID: 35140153 PMCID: PMC8829838 DOI: 10.1136/bmjopen-2021-053237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION SARS-CoV-2 seroprevalence studies are currently being recommended and implemented in many countries. Forming part of the COVID-19 monitoring and evaluation plan of the Catalan Government Health Department, our network aims to initiate a primary healthcare sentinel monitoring system as a surrogate of SARS-CoV-2 exposure in the Barcelona Metropolitan Area. METHODS AND ANALYSIS The seroCAP is a serial cross-sectional study, which will be performed in the Barcelona Metropolitan Area to estimate antibodies against SARS-CoV-2. From February 2021 to March 2022, the detection of serum IgG antibodies against SARS-CoV-2 trimeric spike protein will be performed on a monthly basis in blood samples collected for diverse clinical purposes in three reference hospitals from the three Barcelona healthcare areas (BCN areas). The samples (n=2588/month) will be from patients attended by 30 primary healthcare teams at 30 basic healthcare areas (BHA). A lab software algorithm will systematically select the samples by age and sex. Seroprevalence will be estimated and monitored by age, sex, BCN area and BHA. Descriptive and cluster analysis of the characteristics and distribution of SARS-CoV-2 infections will be performed. Sociodemographic, socioeconomic and morbidity-associated factors will be determined using logistic regression. We will explore the association between seroprevalence, SARS-CoV-2 confirmed cases and the implemented measures using interrupted time series analysis. ETHICS AND DISSEMINATION Ethical approval was obtained from the University Institute Foundation for Primary Health Care Research Jordi Gol i Gurina ethics committee. An informed consent is not required regarding the approval of the secondary use of biological samples within the framework of the COVID-19 pandemic. A report will be generated quarterly. The final analysis, conclusions and recommendations will be shared with the stakeholders and communicated to the general public. Manuscripts resulting from the network will be submitted for publication in peer-reviewed journals.
Collapse
Affiliation(s)
- Alexis Sentís
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Pere Torán
- Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Barcelona, Spain
- Departament de Medicina, Universitat de Girona, Girona, Spain
| | - Juliana Esperalba
- Department of Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Cristina Agustí
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ángel
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
- IDIAP Jordi Gol, Barcelona, Spain
| | - Munoz Gema Fernández
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Eva Dopico
- Microbiology Department, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Betlem Salvador-González
- Unitat de Suport a la Recerca Costa de Ponent, Direcció Atenció Primària Costa de Ponent, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Barcelona, Spain
| | - Maria Victoria González
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Bordas
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
| | - Andrés Antón
- Microbiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Concepció Violan
- Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Mataró, Spain
| | - Marcos Montoro-Fernández
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
| | - Jordi Aceiton
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
| | - Laia Egea-Cortés
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
| | - Lucía Alonso
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
| | | | - Laura Calatayud
- Microbiology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Yolanda Lejardi
- Direcció Assistencial Atenció Primària, Institut Catala De La Salut, Barcelona, Spain
| | - Jacobo Mendioroz
- Subdirecció general de Vigilància i Resposta a Emergències. Agència de Salut Pública de Catalunya, Departament de Salut, Barcelona, Spain
| | | | - Juliana Reyes-Urueña
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Casabona
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT). Department of Health, Generalitat of Catalunya, Badalona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
19
|
Zaldo-Aubanell Q, Serra I, Bach A, Knobel P, I López FC, Belmonte J, Daunis-I-Estadella P, Maneja R. Environmental heterogeneity in human health studies. A compositional methodology for Land Use and Land cover data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150308. [PMID: 34844306 DOI: 10.1016/j.scitotenv.2021.150308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
The use of Land use and Land cover (LULC) data is gradually becoming more widely spread in studies relating the environment to human health. However, little research has acknowledged the compositional nature of these data. The goal of the present study is to explore, for the first time, the independent effect of eight LULC categories (agricultural land, bare land, coniferous forest, broad-leaved forest, sclerophyll forest, grassland and shrubs, urban areas, and waterbodies) on three selected common health conditions: type 2 diabetes mellitus (T2DM), asthma and anxiety, using a compositional methodological approach and leveraging observational health data of Catalonia (Spain) at area level. We fixed the risk exposure scenario using three covariates (socioeconomic status, age group, and sex). Then, we assessed the independent effect of the eight LULC categories on each health condition. Our results show that each LULC category has a distinctive effect on the three health conditions and that the three covariates clearly modify this effect. This compositional approach has yielded plausible results supported by the existing literature, highlighting the relevance of environmental heterogeneity in health studies. In this sense, we argue that different types of environment possess exclusive biotic and abiotic elements affecting distinctively on human health. We believe our contribution might help researchers approach the environment in a more multidimensional manner integrating environmental heterogeneity in the analysis.
Collapse
Affiliation(s)
- Quim Zaldo-Aubanell
- Institute of Environmental Science and Technology (ICTA), Autonomous University of Barcelona (UAB), Z building, ICTA-ICP, Carrer de les columnes, UAB Campus, 08193, Bellaterra, Barcelona, Spain; Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain.
| | - Isabel Serra
- Centre de Recerca Matemàtica, Edifici C, 08193 Bellaterra, Barcelona, Spain; Barcelona Supercomputing Center, 08034 Barcelona, Spain
| | - Albert Bach
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain
| | - Pablo Knobel
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain
| | - Ferran Campillo I López
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Paediatric Environmental Health Specialty Unit, Paediatric Team of the Garrotxa Region, Olot and Garrotxa Region Hospital Foundation, Avinguda Països Catalans 86, 17800 Olot, Catalonia, Spain
| | - Jordina Belmonte
- Institute of Environmental Science and Technology (ICTA), Autonomous University of Barcelona (UAB), Z building, ICTA-ICP, Carrer de les columnes, UAB Campus, 08193, Bellaterra, Barcelona, Spain; Department of Animal Biology, Plant Biology and Ecology, Autonomous University of Barcelona (UAB), C building, UAB Campus 08193, Bellaterra, Barcelona, Spain
| | - Pepus Daunis-I-Estadella
- Department of Computer Science, Applied Mathematics and Statistics, Universitat de Girona, Carrer Universitat de Girona, 6, 17003 Girona, Spain
| | - Roser Maneja
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Geography Department, Autonomous University of Barcelona (UAB), B building, UAB Campus 08193, Bellaterra, Barcelona, Spain
| |
Collapse
|
20
|
Bordas A, Soriano-Arandes A, Subirana M, Malagrida R, Reyes-Urueña JM, Folch C, Soler-Palacin P, Gascón M, Sunyer J, Anton A, Blanco I, Fernández-Morales J, Colom-Cadena A, Sentís A, Pumarola T, Basora J, Casabona J. Study protocol for monitoring SARS-CoV-2 infection and its determinants in Catalonia (Spain): an observational and participatory research approach in a Sentinel Network of Schools. BMJ Open 2022; 12:e055649. [PMID: 35078847 PMCID: PMC8795925 DOI: 10.1136/bmjopen-2021-055649] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Since the SARS-CoV-2 became of concern in January 2020, many preventive measures have been adopted in educational settings to ensure the control of COVID-19 pandemic among children and staff in schools. This study aims to set up a school sentinel surveillance network with the purpose of monitoring SARS-CoV-2 infection, seroprevalence as well as to analyse the impact of preventive interventions of SARS-CoV-2 in school settings. Additionally, we will assess diverse screening strategies in a cohort of students and school staff to monitor the screening acceptance and its potential impact. Altogether, we hope this study will enable the design of more effective strategies for the prevention of COVID-19 spread. METHODS AND ANALYSIS The sentinel schools' study is a cross-sectional, school-based project including 26 participating sentinel schools in Catalonia (Spain). Children, adolescents and staff at the schools will be invited to participate. This project will be carried out from January 2021 to June 2022 as follows: (1) twice yearly serological testing and molecular SARS-CoV-2 detection and questionnaires covering SARS-CoV-2 symptoms, tests, health, knowledge, attitudes and behaviours; (2) an environmental evaluation carried out in different classrooms; (3) SARS-CoV-2 transmission dynamics and the impact of different variants among confirmed cases and classmates; (4) a participatory process by which the participants are invited to act as coinvestigators to evaluate prevention strategies and provide recommendations to improve COVID-19 prevention in schools. Descriptive analysis will be performed for the main variables collected. The incidence and seroprevalence will be calculated and the association with sociodemographic factors and school characteristics will be determined using multivariate logistic regression. ETHICS AND DISSEMINATION Ethical approval was obtained from the IDIAPJGol and the Hospital Universitari Vall d'Hebron ethics committees. A report will be generated quarterly. Findings will be disseminated at national and international conferences and published in peer-reviewed journals.
Collapse
Affiliation(s)
- Anna Bordas
- Centre for Epidemiological Studies of HIV/SIDA and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Catalunya, Spain
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Hospital Vall d'Hebron, Barcelona, Catalunya, Spain
| | - Maria Subirana
- Barcelona Institut for Global Health, IMIM-Parc Salut Mar, Barcelona, Catalunya, Spain
- Universitat Pompeu Fabra, Barcelona, Catalunya, Spain
| | - Rosina Malagrida
- Living Lab for Health, IrsiCaixa AIDS Research Institute, Badalona, Catalunya, Spain
| | - Juliana Maria Reyes-Urueña
- Centre for Epidemiological Studies of HIV/SIDA and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Catalunya, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Cinta Folch
- Centre for Epidemiological Studies of HIV/SIDA and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Catalunya, Spain
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Pere Soler-Palacin
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Hospital Vall d'Hebron, Barcelona, Catalunya, Spain
| | - Mireia Gascón
- Universitat Pompeu Fabra, Barcelona, Catalunya, Spain
- Centre for International Health Research (CRESIB), ISGlobal, Barcelona, Catalunya, Spain
| | - Jordi Sunyer
- Universitat Pompeu Fabra, Barcelona, Catalunya, Spain
- IMIM-Parc Salut Mar, ISGlobal, Barcelona, Catalunya, Spain
| | - Andres Anton
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Institut Català de la Salut, Barcelona, Catalunya, Spain
| | - Ignacio Blanco
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut D'Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP), Institut Català de la Salut, Barcelona, Catalunya, Spain
| | | | - Andreu Colom-Cadena
- Centre for Epidemiological Studies of HIV/SIDA and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Catalunya, Spain
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Alexis Sentís
- Centre for Epidemiological Studies of HIV/SIDA and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Catalunya, Spain
- Epiconcept SAS, Paris, Île-de-France, France
| | - Tomas Pumarola
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Institut Català de la Salut, Barcelona, Catalunya, Spain
| | - Josep Basora
- Foundation University Institute for Research in Primary Health Care Jordi Gol i Gurina (IDIAP Jordi Gol), Barcelona, Catalunya, Spain
| | - Jordi Casabona
- Centre for Epidemiological Studies of HIV/SIDA and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Catalunya, Spain
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| |
Collapse
|
21
|
Marin-Gomez FX, Mendioroz-Peña J, Mayer MA, Méndez-Boo L, Mora N, Hermosilla E, Coma E, Vilaseca JM, Leis A, Medina M, Catalina QM, Vidal-Alaball J. Comparing the Clinical Characteristics and Mortality of Residential and Non-Residential Older People with COVID-19: Retrospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:483. [PMID: 35010742 PMCID: PMC8744689 DOI: 10.3390/ijerph19010483] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 01/08/2023]
Abstract
Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people.
Collapse
Affiliation(s)
- Francesc X. Marin-Gomez
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08772 St. Fruitós de Bages, Spain; (F.X.M.-G.); (J.M.-P.); (J.V.-A.)
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08772 St. Fruitós de Bages, Spain;
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain;
| | - Jacobo Mendioroz-Peña
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08772 St. Fruitós de Bages, Spain; (F.X.M.-G.); (J.M.-P.); (J.V.-A.)
- COVID-19 Response Unit, Department of Health, Generalitat de Catalunya, 08005 Barcelona, Spain
| | - Miguel-Angel Mayer
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, 08003 Barcelona, Spain;
| | - Leonardo Méndez-Boo
- Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), 08007 Barcelona, Spain; (L.M.-B.); (N.M.); (E.H.); (E.C.); (M.M.)
| | - Núria Mora
- Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), 08007 Barcelona, Spain; (L.M.-B.); (N.M.); (E.H.); (E.C.); (M.M.)
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Eduardo Hermosilla
- Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), 08007 Barcelona, Spain; (L.M.-B.); (N.M.); (E.H.); (E.C.); (M.M.)
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Ermengol Coma
- Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), 08007 Barcelona, Spain; (L.M.-B.); (N.M.); (E.H.); (E.C.); (M.M.)
| | - Josep-Maria Vilaseca
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain;
| | - Angela Leis
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, 08003 Barcelona, Spain;
| | - Manolo Medina
- Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), 08007 Barcelona, Spain; (L.M.-B.); (N.M.); (E.H.); (E.C.); (M.M.)
| | - Queralt Miró Catalina
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08772 St. Fruitós de Bages, Spain;
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08772 St. Fruitós de Bages, Spain; (F.X.M.-G.); (J.M.-P.); (J.V.-A.)
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08772 St. Fruitós de Bages, Spain;
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain;
| |
Collapse
|
22
|
Lansburgh F, Jacques-Aviñó C, Pons-Vigués M, Morgan R, Berenguera A. Time for themselves: Perceptions of physical activity among first and second-generation Pakistani women living in the Raval, Barcelona. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221078738. [PMID: 35168422 PMCID: PMC8855417 DOI: 10.1177/17455057221078738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/14/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Pakistani women experience higher-than-average rates of certain chronic diseases, including diseases related to sedentary lifestyles. The aim of this study is to explore how first and second-generation Pakistani women living in the Raval, Barcelona, conceive of physical activity, and their barriers and facilitators around participating in physical activity, with the goal of increasing physical activity in this group. METHODS Qualitative research with an intersectional approach. Nine informal interviews with key community informants were conducted from November 2018 to January 2019 to gain background on the topic, using snowball sampling. Eleven individual interviews were conducted from February to June 2019. Seven were with Pakistani women having lived, or currently living, in the neighborhood of the Raval, Barcelona. Four additional interviews were conducted with non-Pakistani women key community informants who have worked extensively with this community. Thematic content analysis was carried out using ATLAS.ti. RESULTS First-generation Pakistani women generally did not have physical activity present in their daily lives, but by most accounts wished to. Areas that shed light on this included the following: limited economic opportunities and associated living conditions, barriers to social integration, health concepts and access to information, and cultural norms and related gender roles. For the first-generation, gender-related divisions of labor as well as the absence of the concept of self-care were particularly relevant barriers to their participation in physical activity. The experience of immigration-related grief emerged as a transversal theme which overlapped with multiple areas. While both generations expressed a need for the separation of genders during physical activity-as per their cultural interpretation of Islam-the lack of such spaces was highlighted as a principal barrier in physical activity among the second generation. CONCLUSION These findings shed light on distinct elements that exert influence in Pakistani women immigrants' participation in physical activity-among them: social and living conditions, access to public space, and gender-related work distribution and cultural norms-which are in turn influenced by first or second-generation immigration status. Considering the specific needs of both groups when proposing politics and health programs to encourage physical activity is paramount in order to successfully partner with these populations.
Collapse
Affiliation(s)
- Flora Lansburgh
- Fundació Institut Universitari per a la
recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona,
Spain
- Universitat Autònoma de Barcelona,
Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona,
Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la
recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona,
Spain
- Universitat Autònoma de Barcelona,
Barcelona, Spain
| | - Mariona Pons-Vigués
- Servei Català de la Salut (CatSalut),
Barcelona, Spain
- Universitat de Girona, Girona,
Spain
| | - Rosemary Morgan
- Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, USA
| | - Anna Berenguera
- Fundació Institut Universitari per a la
recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona,
Spain
- Universitat Autònoma de Barcelona,
Barcelona, Spain
| |
Collapse
|
23
|
Serra-Pujadas S, Alonso-Buxadé C, Serra-Colomer J, Folguera J, Carrilero N, García-Altés A. Geographical, Socioeconomic, and Gender Inequalities in Opioid Use in Catalonia. Front Pharmacol 2021; 12:750193. [PMID: 34744729 PMCID: PMC8568127 DOI: 10.3389/fphar.2021.750193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/24/2021] [Indexed: 01/21/2023] Open
Abstract
Background: In recent years, worldwide opioid use has seen a sharp increase, especially for the treatment of chronic non-cancer pain. Catalonia is no exception to this trend. However, no recent studies have addressed the socioeconomic and gender inequalities in opioid use in the different geographical areas of Catalonia. Methods: We performed an ecological study to analyse the associations between socioeconomic status, gender and the use of opioids in the 372 Health Areas of Catalonia. Robust Poisson models were performed to analyse the data provided from the Central Register of Insured Persons and dispensing data from the Electronic Prescription Database. Results: The results show that socioeconomic status has a major impact on opioid use, with the most deprived areas presenting the highest levels of use. There are major inequalities in the DDD/1,000 inhabitants per areas. Moreover, women have much higher utilization rates than men, especially in more deprived areas. The greatest difference is observed in the use of weak opioids in women: the DDD/1,000 inhabitants per day was 2.34 in the area with the lowest use, compared with 22.18 in the area with the highest use. Conclusions: Our findings suggest that stronger action is needed to promote best practices in prescribing for chronic pain and to reduce socioeconomic and gender variation between geographical areas. This study provides a model for routine monitoring of opioid prescription for targeted interventions aimed at lowering high-dose consumption in specifically identified areas.
Collapse
Affiliation(s)
- Sara Serra-Pujadas
- Facultat d'Economia i Empresa, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Júlia Folguera
- Facultat d'Economia i Empresa, Universitat Pompeu Fabra, Barcelona, Spain
| | - Neus Carrilero
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
| | - Anna García-Altés
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| |
Collapse
|
24
|
Deprivation Index and Lifestyle: Baseline Cross-Sectional Analysis of the PREDIMED-Plus Catalonia Study. Nutrients 2021; 13:nu13103408. [PMID: 34684409 PMCID: PMC8540452 DOI: 10.3390/nu13103408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 01/26/2023] Open
Abstract
This baseline cross-sectional analysis from data acquired in a sub-sample of the PREDIMED-Plus study participants aimed to evaluate the relation between the Composite Socioeconomic Index (CSI) and lifestyle (diet and physical activity). This study involved 1512 participants (759 (52.2%) women) between 55 and 80 years with overweight/obesity and metabolic syndrome assigned to 137 primary healthcare centers in Catalonia, Spain. CSI and lifestyle (diet and physical activity) were assessed. Multiple linear regression or multinomial regression were applied to the data. Cluster analysis was performed to identify dietary patterns. The multiple linear regression model showed that a high deprivation index was related to a higher consumption of refined cereals (11.98 g/d, p-value = 0.001) and potatoes (6.68 g/d, p-value = 0.001), and to a lower consumption of fruits (−17.52 g/d, p-value = 0.036), and coffee and tea (−8.03 g/d, p-value = 0.013). Two a posteriori dietary patterns were identified by cluster analysis and labeled as “healthy” and “unhealthy”. In addition, the multinomial regression model showed that a high deprivation index was related to an unhealthy dietary pattern and low physical activity (OR 1.42 [95% CI 1.06–1.89]; p-value < 0.05). In conclusion, a high deprivation index was related to an unhealthy lifestyle (diet and physical activity) in PREDIMED-Plus study participants.
Collapse
|
25
|
Ibáñez-Sanz G, Milà N, Vidal C, Rocamora J, Moreno V, Sanz-Pamplona R, Garcia M. Positive impact of a faecal-based screening programme on colorectal cancer mortality risk. PLoS One 2021; 16:e0253369. [PMID: 34191813 PMCID: PMC8244848 DOI: 10.1371/journal.pone.0253369] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/27/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The effectiveness of colorectal cancer (CRC) screening programs is directly related to participation and the number of interval CRCs. The objective was to analyse specific-mortality in a cohort of individuals invited to a CRC screening program according to type of CRC diagnosis (screen-detected cancers, interval cancers, and cancers among the non-uptake group). MATERIAL AND METHODS Retrospective cohort that included invitees aged 50-69 years of a CRC screening program (target population of 85,000 people) in Catalonia (Spain) from 2000-2015 with mortality follow-up until 2020. A screen-detected CRC was a cancer diagnosed after a positive faecal occult blood test (guaiac or immunochemical); an interval cancer was a cancer diagnosed after a negative test result and before the next invitation to the program (≤24 months); a non-uptake cancer was a cancer in subjects who declined screening. RESULTS A total of 624 people were diagnosed with CRC (n = 265 screen-detected, n = 103 interval cancers, n = 256 non-uptake). In the multivariate analysis, we observed a 74% increase in mortality rate in the group with interval CRC compared to screen-detected CRC adjusted for age, sex, location and stage (HR: 1.74%, 95% CI:1.08-2.82, P = 0.02). These differences were found even when we restricted for advanced-cancers participants. In the stratified analysis for type of faecal occult blood test, a lower mortality rate was only observed among FIT screen-detected CRCs. CONCLUSION CRC screening with the FIT was associated with a significant reduction in CRC mortality.
Collapse
Affiliation(s)
- Gemma Ibáñez-Sanz
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Gastroenterology Department, Bellvitge University Hospital -IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Colorectal Cancer research group, ONCOBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Núria Milà
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Early Detection of Cancer Research Group, EPIBELL Program, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Early Detection of Cancer Research Group, EPIBELL Program, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Judith Rocamora
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Víctor Moreno
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Colorectal Cancer research group, ONCOBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Rebeca Sanz-Pamplona
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Colorectal Cancer research group, ONCOBELL Programme, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Montse Garcia
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Early Detection of Cancer Research Group, EPIBELL Program, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat, Barcelona, Spain
| | | |
Collapse
|
26
|
Politi J, Martín-Sánchez M, Mercuriali L, Borras-Bermejo B, Lopez-Contreras J, Vilella A, Villar J, Orcau A, de Olalla PG, Rius C. Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 34018483 PMCID: PMC8138960 DOI: 10.2807/1560-7917.es.2021.26.20.2001138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Population-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated. Aim We describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain. Methods This population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES. Results Of 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46–83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975–1,047); hospitalisation: 619 (95% CI: 591–648); mortality: 150 (95% CI: 136–165)) and lowest in the most affluent (incidence: 784 (95% CI: 759–809); hospitalisation: 400 (95% CI: 382–418); mortality: 121 (95% CI: 112–131)). Conclusions COVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.
Collapse
Affiliation(s)
- Julieta Politi
- Preventive Medicine and Public Health Training Unit, PSMar-UPF-PHAB (Parc de Salut Mar - Pompeu Fabra University - Public Health Agency of Barcelona), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Mario Martín-Sánchez
- Preventive Medicine and Public Health Training Unit, PSMar-UPF-PHAB (Parc de Salut Mar - Pompeu Fabra University - Public Health Agency of Barcelona), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Lilas Mercuriali
- Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Blanca Borras-Bermejo
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquín Lopez-Contreras
- Infectious Diseases-Internal Medicine, Hospital de Sant Pau-Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Vilella
- Preventive Medicine and Epidemiology Department, Hospital Clínic, Barcelona, Spain
| | - Judit Villar
- Service of Infectious Diseases, Hospital del Mar, Barcelona, Spain
| | -
- Members are listed under Investigators
| | - Angels Orcau
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Patricia Garcia de Olalla
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Cristina Rius
- Department of Pediatrics, Obstetrics, Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| |
Collapse
|
27
|
Community Risk Factors in the COVID-19 Incidence and Mortality in Catalonia (Spain). A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073768. [PMID: 33916590 PMCID: PMC8038505 DOI: 10.3390/ijerph18073768] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/23/2022]
Abstract
The heterogenous distribution of both COVID-19 incidence and mortality in Catalonia (Spain) during the firsts moths of the pandemic suggests that differences in baseline risk factors across regions might play a relevant role in modulating the outcome of the pandemic. This paper investigates the associations between both COVID-19 incidence and mortality and air pollutant concentration levels, and screens the potential effect of the type of agri-food industry and the overall land use and cover (LULC) at area level. We used a main model with demographic, socioeconomic and comorbidity covariates highlighted in previous research as important predictors. This allowed us to take a glimpse of the independent effect of the explanatory variables when controlled for the main model covariates. Our findings are aligned with previous research showing that the baseline features of the regions in terms of general health status, pollutant concentration levels (here NO2 and PM10), type of agri-food industry, and type of land use and land cover have modulated the impact of COVID-19 at a regional scale. This study is among the first to explore the associations between COVID-19 and the type of agri-food industry and LULC data using a population-based approach. The results of this paper might serve as the basis to develop new research hypotheses using a more comprehensive approach, highlighting the inequalities of regions in terms of risk factors and their response to COVID-19, as well as fostering public policies towards more resilient and safer environments.
Collapse
|
28
|
Coma E, Mora N, Peremiquel-Trillas P, Benítez M, Méndez L, Mercadé A, Fina F, Fàbregas M, Medina M. Influence of organization and demographic characteristics of primary care practices on continuity of care: analysis of a retrospective cohort from 287 primary care practices covering about 6 million people in Catalonia. BMC FAMILY PRACTICE 2021; 22:56. [PMID: 33761874 PMCID: PMC7992318 DOI: 10.1186/s12875-021-01414-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/11/2021] [Indexed: 11/10/2022]
Abstract
Background There is evidence that an ongoing patient-physician relationship is associated with improved health outcomes and more efficient health systems. The main objective of this study is to describe the continuity of care in primary healthcare in Catalonia (Spain) and to analyze whether the organization of primary care practices (PCP) or their patients’ sociodemographic characteristics play a role in its continuity of care. Methods Four indices were used to measure continuity of care: Usual Provider Index (UPC), Modified Modified Continuity Index (MMCI), Continuity of Care Index (COC), and Sequential Continuity Index (SECON). The study was conducted on 287 PCP of the Catalan Institute of Health (Institut Català de la Salut—ICS). Each continuity of care index was calculated at the patient level (3.2 million patients and 35.5 million visits) and then aggregated at the PCP level. We adjusted linear regression models for each continuity index studied, considering the result of the index as an independent variable and demographic and organizational characteristics of the PCP as explanatory variables. Pearson correlation tests were used to compare the four continuity of care indices. Results Indices’ results were: UPC: 70,5%; MMCI: 73%; COC: 53,7%; SECON: 60,5%. The continuity of care indices had the highest bivariate correlation with the percentage of appointments booked with an assigned health provider (VISUBA variable: the lower the value, the higher the visits without an assigned health provider, and thus an organization favoring immediate consultation). Its R2 ranged between 56 and 63%, depending on the index. The multivariate model which explained better the variability of continuity of care indices (from 49 to 56%) included the variables VISUBA and rurality with a direct relationship; while the variables primary care physician leave days and training practices showed an inverse relationship. Conclusion Study results suggest that an organization of primary care favoring immediate consultation is related to a lower continuity of patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01414-y.
Collapse
Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.
| | - Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Preventive Medicine and Epidemiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mència Benítez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.,Equip d'Atenció Primària Gòtic, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Leonardo Méndez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Albert Mercadé
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| |
Collapse
|
29
|
Vivanco-Hidalgo RM, Molina I, Martinez E, Roman-Viñas R, Sánchez-Montalvá A, Fibla J, Pontes C, Velasco Muñoz C. Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 33663646 PMCID: PMC7934222 DOI: 10.2807/1560-7917.es.2021.26.9.2001202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Several clinical trials have assessed the protective potential of chloroquine and hydroxychloroquine. Chronic exposure to such drugs might lower the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or severe coronavirus disease (COVID-19). Aim To assess COVID-19 incidence and risk of hospitalisation in a cohort of patients chronically taking chloroquine/hydroxychloroquine. Methods We used linked health administration databases to follow a cohort of patients with chronic prescription of hydroxychloroquine/chloroquine and a control cohort matched by age, sex and primary care service area, between 1 January and 30 April 2020. COVID-19 cases were identified using International Classification of Diseases 10 codes. Results We analysed a cohort of 6,746 patients (80% female) with active prescriptions for hydroxychloroquine/chloroquine, and 13,492 controls. During follow-up, there were 97 (1.4%) COVID-19 cases in the exposed cohort and 183 (1.4%) among controls. The incidence rate was very similar between the two groups (12.05 vs 11.35 cases/100,000 person-days). The exposed cohort was not at lower risk of infection compared with controls (hazard ratio (HR): 1.08; 95% confidence interval (CI): 0.83–1.44; p = 0.50). Forty cases (0.6%) were admitted to hospital in the exposed cohort and 50 (0.4%) in the control cohort, suggesting a higher hospitalisation rate in the former, though differences were not confirmed after adjustment (HR: 1·46; 95% CI: 0.91–2.34; p = 0.10). Conclusions Patients chronically exposed to chloroquine/hydroxychloroquine did not differ in risk of COVID-19 nor hospitalisation, compared with controls. As controls were mainly female, findings might not be generalisable to a male population.
Collapse
Affiliation(s)
- Rosa Maria Vivanco-Hidalgo
- These authors contributed equally.,Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut Generalitat de Catalunya, Carrer de Roc Boronat 81-95, Barcelona, Spain
| | - Israel Molina
- Infectious Diseases Department, Hospital Universitario Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.,These authors contributed equally
| | - Elisenda Martinez
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut Generalitat de Catalunya, Carrer de Roc Boronat 81-95, Barcelona, Spain
| | - Ramón Roman-Viñas
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut Generalitat de Catalunya, Carrer de Roc Boronat 81-95, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Infectious Diseases Department, Hospital Universitario Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Fibla
- Institut de Recerca Biomedica de Lleida, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Unitat de Genètica Humana, Departament de Ciències Mèdiques Bàsiques, Universitat de Lleida, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain
| | - Caridad Pontes
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193 Cerdanyola del Vallès, Barcelona, Spain.,Gerència del Medicament - Àrea Assistencial, Servei Català de la Salut, Travessera de les Corts, 131-159, 08028 Barcelona, Spain
| | - César Velasco Muñoz
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut Generalitat de Catalunya, Carrer de Roc Boronat 81-95, Barcelona, Spain
| | -
- Members of the Real World Data Working Group have been acknowledged at the end of the article
| |
Collapse
|